Our dad was in two different nursing homes.  Our first experience was not so good, and so we made a change.  Luckily, our next experience was a success.  Here are the five most valuable things we learned.

1. Make sure medications and corresponding tests are being appropriately administered

"Look at your dad’s arms," my mother exclaimed as I arrived at the nursing home for a visit.  I hadn’t been there in five weeks. "Don’t they look great?!" she asked happily.  Her point was that Dad’s arms weren’t filled with black and blue marks, as was usually the case from the endless blood tests.  Because our dad was on the blood-thinning medication Coumadin, it was necessary to have regular tests to monitor the density of his blood.  Thus, his arms looking untouched worried me. 

With a bit of alarm I walked out to find his regular nurse and asked if he’d been taking his Coumadin.  “No,” she responded, “he’s not on Coumadin.”  I found this curious, the sudden change in his medication.  I asked her if she wouldn’t mind pulling his chart and reviewing it with me.  As she turned the pages, she said, “Oh yes, you’re right, we have been giving him Coumadin.” 

And so I asked, “When was the last time you gave him a blood test?”  She quickly scanned the pages and her face went blank.

“Oh no . . . We haven’t been.”

The nurses in this home did initially seem competent, but no one actually seemed to be “in charge” of a particular patient’s care.  There were many more medication mistakes to come in this particular nursing home, and so we became diligent in double-checking the medication routine.

2. Make sure that doctor’s orders are being followed

There was actually a nurse at one facility who told us straight up that she wasn’t going to follow the doctor’s orders because she claimed that she knew better.  Maybe she did, but either way it didn’t give us a good feeling.  We also had staff members not following doctor’s instructions because they didn’t check on the orders.  From ignoring them outright or not being aware of medication changes, the lack of regard for doctor’s orders was disconcerting.  But even in the best-run facility, things fall through the cracks.  So we learned to be diligent regarding doctor’s orders, making sure they were indeed being followed.

3. Make sure the staff knows how to handle your parent’s health issue

This never occurred to us, until one night an emergency room nurse filled us in.  The night nurse at the home had sent our dad to the emergency room in the middle of the night.  She felt that he was being difficult and disruptive.  The emergency room nurse felt differently.  She felt that this particular nursing home employee didn't have the training or knowledge to handle the situation properly.  She told our mom, "She [the nursing home nurse] just made the situation worse.”  To make matters a little more frustrating, Medicare didn’t think the emergency room visit was necessary either, and so they decided it wouldn't be covered, leaving us with an ambulance bill on top of some of the hospital charges.

Contrast that story to this:  At the other nursing home, they became concerned that our dad was sleeping all day.  He had just had his second leg amputated and understandably he was in deep depression for a couple of weeks.  His physical therapist had an idea.  She invited a double amputee to visit our dad.  He stopped by a couple of times to give our dad words of encouragement and a sense that a productive life was still possible.  It was just what our dad needed to bring him back.

Having a staff that is engaged and sensitive to your parent’s needs is vital.

4. Make sure the home has a leader

Adele Anahory was our savior.   Adele is the director of nursing at Life Care in Ocala, Florida.  We had a good experience at Life Care for many reasons, including their capable staff of nurses, aides, physical therapists, and their business office.  But to us, Adele made the real difference.  She's a leader.  Everyday her office is filled with people looking for guidance and answers.  The most important thing she did for our family was making it her personal mission to solve our problems.  Nothing was too big or small.  This was a dramatic switch from the previous home which made sure to dump all of their problems on our already stressed-out mother.  As in any industry, a successful organization needs inspired and capable leadership.  Adele sets the tone of compassion and engagement at Life Care.

5. Make a change if necessary

There’s that old adage: “The devil you know is better than the devil you don’t know.”  We actually believed that all nursing homes were inherently bad and, therefore, why move our dad at all?  After all, change was not easy for him.  But after the emergency room fiasco, we decided it was necessary to make a switch.  And we found out something important:  Not all nursing homes are alike.  Some are bad, but some are, in fact, good.  The move proved to be situation-altering, and we were so relieved that we had made the move.  So don't hesitate if your parent's situation is not good.  Make the move!